Association of Immune Thrombocytopenia and Inflammatory Bowel Disease in Children

J Clin Med. 2021 Apr 30;10(9):1940. doi: 10.3390/jcm10091940.

Angela Guarina 1, Angelica Barone 2, Assunta Tornesello 3, Maddalena Marinoni 4, Giuseppe Lassandro 5, Paola Giordano 5, Milena Motta 6, Marco Spinelli 7, Ilaria Fontanili 2, Fiorina Giona 8, Francesco Menna 9, Elena Chiocca 10, Ilaria Fotzi 10, Angelamaria Petrone 11, Francesco Graziano 12, Paola Saracco 13, Giuseppe Puccio 1, Michele Citrano 12, Giovanna Russo 6, Piero Farruggia 1


Author information

  • 1UOC Oncoematologia Pediatrica-ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy.
  • 2UO Pediatria e Oncoematologia-AOU, 43126 Parma, Italy.
  • 3UOC Di Oncoematologia Pediatrica-PO "Vito Fazzi", 73100 Lecce, Italy.
  • 4SSD Oncoematologia Pediatrica-Ospedale Filippo Del Ponte, Varese ASST Settelaghi, 21100 Varese, Italy.
  • 5Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", 70121 Bari, Italy.
  • 6UOC Ematologia ed Oncologia Pediatrica-AOU Policlinico "Rodolico-San Marco", Università di Catania, 95131 Catania, Italy.
  • 7Fondazione MBBM/AO San Gerardo Clinica Pediatrica Universitaria, 20900 Monza, Italy.
  • 8Policlinico Umberto I, Università La Sapienza, 00185 Roma, Italy.
  • 9Dipartimento di Oncoematologia-AORN Santobono-Pausilipon, 80122 Napoli, Italy.
  • 10Oncologia, Ematologia e TCSE-Centro di Eccellenza di Oncologia ed Ematologia-AOU A. Meyer, 50139 Firenze, Italy.
  • 11UOM Pediatria Ospedale S. Chiara, 38122 Trento, Italy.
  • 12UO di Pediatria-Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy.
  • 13Dipartimento di Scienze Pediatriche e dell'Adolescenza, SC Pediatria Specialistica Universitaria, AOU Città della Salute e della Scienza, Presidio Ospedale Infantile Regina Margherita, 10126 Torino, Italy.


Background: The association between inflammatory bowel disease (IBD) and immune thrombocytopenia (ITP) is still uncertain. In this multicenter retrospective study, the coexistence of both diseases was investigated in children diagnosed from 1 January 2000 to 31 December 2019.

Methods: Clinical characteristics of both IBD and ITP, onset of disorders, and patient's response to treatment were collected through a structured form sent to 55 Italian pediatric referring centers for hematological disorders.

Result: Centers responded to the survey and reported the coexistence of IBD and ITP in 14 children. The first diagnosis was ITP in 57.1% and IBD in 35.7% of patients: it was simultaneous in 7.1%. IBD was classified as ulcerative colitis (57.1%), Crohn disease (35.7%), and unclassified (7.1%). No therapy for IBD other than steroids had any effect on ITP course. Colectomy resulted in recovery from ITP in 1 of the 2 patients surgically treated. ITP was always mild but turned to be chronic in half of patients.

Conclusions: In all patients, ITP was mild without any evident impact on IBD severity, but the incidence of chronic ITP seems to be higher than what is usually observed in the pediatric age group. Colectomy had unpredictable effects on ITP.

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